Direct oral anticoagulants versus vitamin K antagonists in the treatment of left ventricular thrombosis: a systematic review and meta-analysis

Direct oral anticoagulants for the treatment of left ventricular thrombosis: an updated systematic review and meta-analysis

“…Nevertheless, a supplementary analysis applying a fixed-effect model showed statistical significance (pooled OR 0.51, 95% CI 0.29–0.91). On the one hand, our findings are also in line with those from Condello et al 10 showing a significant reduction of ischemic stroke with DOAC versus warfarin, with a similar rate of thrombosis resolution and a reduced risk of bleeding. On the other hand, Burmeister et al 11 showed a higher rate of LVT resolution with a similar risk of a thromboembolic event, ischemic stroke and major bleeding.…”

“…On the other hand, Burmeister et al 11 showed a higher rate of LVT resolution with a similar risk of a thromboembolic event, ischemic stroke and major bleeding. It is worthwhile to mention that despite the large number of studies included by Condello et al 10 (22) and by Burmeister et al 11 (11), both included in their analysis also effect sizes from only abstract publications and therefore more prone to reporting bias. Although only preliminary and requiring further confirmation, our data should reassure physicians facing this challenging condition.…”

“…Despite only a few, and not enough powered randomized clinical trials that have tested a treatment strategy with DOACs compared with VKAs in this setting, due to the growing interest, the findings of many observational studies have become available during the last 2 years, and some meta-analyses have already been published. [8][9][10][11] However, more than six studies were published in 2021, which have not been included in previous meta-analyses. This updated metaanalysis aims to include the latest and newly available evidence and studies comparing DOACs versus VKAs for LVT, assessing the safety and efficacy of the treatment.…”

“…Even if direct oral anticoagulants (DOACs) are widely used for systemic embolism prevention, their efficacy and safety in the setting of LVT are not proven. Despite only a few, and not enough powered randomized clinical trials that have tested a treatment strategy with DOACs compared with VKAs in this setting, due to the growing interest, the findings of many observational studies have become available during the last 2 years, and some meta-analyses have already been published 8–11 . However, more than six studies were published in 2021, which have not been included in previous meta-analyses.…”

Another meta-analysis on novel oral anticoagulants for left ventricular thrombus: when enough is enough?

“…1). 7–11 Serenelli et al 6 argue that their analysis updates the results of previously published ones, thanks to the inclusion of data from recently available studies. Including in the results of Serenelli et al , 6 a separate analysis of newly released studies alone might have helped accomplishing both a corroboration and a greater relevance of the outcomes.…”